Probiotics: What You Need to Know

Sales of probiotics are on the rise, but getting the benefits you want may be more complicated than nomming on the first cup of yogurt you see. Find out what you need to know to get your microbes straight.

What are they?

Probiotics contain beneficial strains of bacteria that may be able to help with certain health issues. Probiotics are available to consumers in oral products such as dietary supplements and yogurts, as well as other products such as suppositories and creams. As with other supplements, the FDA does not allow companies to advertise probiotics as a treatment, prevention, or cure for any disease but scientific studies on probiotics show some benefits in helping certain conditions.

What can they do?

Not all probiotics are created equal. There are many different strains of bacteria sold in probiotics, and different strains are effective for different health concerns.

So just because something advertises itself as probiotic—Activia yogurt, for instance, which has allegedly crossed the bad ad line before—doesn’t mean it will have all the effects you’re hoping it will have.

More research still needs to be done on all applications, but here’s a rundown of where experts say probiotics have proven to be of some help.

Strong Consensus

• Diarrhea – One of the most promising uses of probiotics appears to be in cases of acute and antibiotic-related diarrhea. The strains to look out for are Lactobacillus GG and S. boulardii.
• Atopic eczema – atopic eczema is a skin condition usually found in infants. Lactobacillus GG has been shown to be possibly effective in its treatment.
• Necrotizing enterocolitis – Bifidobacterium and L. acidophilus have been shown to be helpful in cases of necrotizing enterocolitis, an intestinal disease found mostly in premature infants.

Promising, But Needs More Research 

• Immunity – There is evidence that probiotics affect the immune system, but it’s not yet clear which strains do what or how they can be used clinically. In one study, a combination of probiotics reduced the severity of respiratory tract infections, but did not prevent people from getting sick in the first place.
• Irritable bowel syndrome (IBS)– Probiotics seem to be generally helpful for some IBS symptoms, but scientists do not yet have enough information to be sure which strain or combination of strains are effective for which symptoms. Two strains that seem promising are B. infantis 35624 and L. plantarum DSM9843.
• Urogenital health – Some studies have shown probiotics may be helpful in treating vaginal and urinary infections. Look for L. rhamnosus GR-1 and L. reuteri RC-14.
• Ulcerative colitis – In one study, a probiotic supplement that contained Bifidobacterium breve, B. longum, B. infantis, Lactobacillus acidophilus, L. plantarum, L. paracasei, L. bulgaricus, and Streptococcus thermophiles helped patients recover from ulcerative colitis.

Not Enough Evidence

There is not enough evidence at this time to conclude that probiotics are effective for Crohn’s disease, diabetes, obesity, or autism.

Other issues to keep in mind

• Some probiotics need to be refrigerated in order to keep the bacteria active. If a supplement indicates on the label that it should be refrigerated but is sold or shipped unrefrigerated, it may not be effective.
• Quality varies. Consumerlab.com tested a variety of different probiotics, and found two that overstated the number of active cells on their label. The products were:
  • Nutrition Now PB8, which contained only 56.8% of its stated 14 billion active cells per serving, and
  • I-Flora Kids Multi-Probiotic, which contained only 65% of its stated 8 billion cells per serving.
• When experimenting with different probiotics, take note of the number of active cells. It varies wildly, from one billion to 255 billion. The number of active cells affects how the product will work.

At the end of the day, the science behind probiotics is promising but still in its early stages. There are a lot of products out there and a lot of advertising to go along with them, but maybe talk to your doctor and do your research before mainlining the kombucha.